Medical Politics

Health Politics. Politics affects health, hospital management, physicians and patients in a big way. Dr. David Samadi will explore major national and global health political issues and debates affecting the patient outcome. Learn what you need to know and get Dr. Samadi's take.

HEALTH POLITICS

President Obama is urging Congress to double the funding to confront the danger of antibiotic-resistant bacteria. The White House said it’s a major public health issue that, if left unchecked, would cause tens of thousands of deaths and millions of illnesses.

White House's Plan To Fight Infectious Disease

Wants to double the amount of federal funding for combating and preventing antibiotic resistance to more than $1.2 billion

The plan calls for:

Improved surveillance of outbreaks

Better diagnostic tests

New research on alternative drugs

Plan also urges government agencies to reinforce systems to track the consumption of antibiotics and to reduce inappropriate use in people and animals

Experts are praising the administration for finally focusing on a problem that infectious disease doctors had been warning about for years. Many said the strategy should have recommended tougher measures against the overuse of antibiotics in agriculture, which, they argue, is a huge part of the problem. The new plan’s actions are focused on curbing use in humans.

It calls on federal agencies like the CDC to create a tougher surveillance system to monitor the use of antibiotics in hospitals and other medical settings, which includes specific steps that hospitals participating in Medicaid and Medicare must take to reduce inappropriate use.

Americans use more antibiotics than people in other industrialized nations. They're used at rates more than twice those in Germany and the Netherlands. Some health advocates remain unimpressed by the proposed actions on antibiotic use in animals. They say the plan continues to allow the routine feeding of antibiotics to animals that live in the crowded conditions endemic to industrial farms.

Warnings on Antibiotic Resistance

Researchers have been warning for years that antibiotics are losing their power because of overuse. Some warn that if the trend is not stopped, the world could return to the time before antibiotics, when it was common for people to die from ordinary infections and for children not to survive illnesses like strep throat.

One problem has been a lack of data. Some say Obama’s plan lacks specifics on how that would be addressed.

More than 70% of the antibiotics sold in the United States goes to chicken, pigs, cows and other animals that people eat

Producers of meat and poultry are not required to report how they use the drugs

i.e. which ones, on what types of animals, in what quantities

Makes it difficult to document the relationship between routine antibiotic use in animals and antibiotic-resistant infections in people

Plan calls for “enhanced summary reports on the sale of distribution and antibiotics” used in food animals, but without specifying how that would be done

We take antibiotics for granted for a lot of illnesses that can be deadly and debilitating. Part of the solution is not just finding replacements for traditional antibiotics, but also making sure we use antibiotics properly. It’s important for people, not just doctors, to understand why antibiotic resistance is important

HISTORY OF ANTIBIOTICS

The discovery of antibiotics was one of the most significant medical achievements of the 20th century. First antibiotic, penicillin was discovered in 1928. In the pre-antibiotic era of the early 1900s, people had no medicines against common germs and as a result, human disease was prevalent

Infections that are easily treated today killed millions of people around the world

More people (an estimated 30 million) died from the influenza epidemic of 1918–1919 than were killed during World War I

Before antibiotics, 90% of children with bacterial meningitis died

Strep throat was at times a fatal disease

Ear infections sometimes spread from the ear to the brain, causing severe problems

Other serious infections, from tuberculosis to pneumonia to whooping cough, were caused by aggressive bacteria that reproduced with extraordinary speed and led to serious illness and sometimes death

The discovery of penicillin was followed by the discovery and development of other antibiotics, leading physicians, health officials, and the public alike to believe that they would protect us from all infectious diseases. However, evolution of antibiotics was not accounted for.

WHAT IS ANTIBIOTIC RESISTANCE?

• Resistance occurs when an antibiotic is no longer effective at killing or limiting the growth of bacteria. It can occur naturally or can be acquired through previous exposure to an antibiotic or through contact with another organism that is resistant.

There are several ways that bacteria can resist the effects of antibiotics:

Bacteria can develop the ability to neutralize the antibiotic before it can harm them

Bacteria can change the antibiotic attack site so it cannot affect the function of the bacteria

Bacteria can pump the antibiotic out of the cell or prevent the antibiotic from getting into the cell

Once bacteria are resistant, the infections they cause may not be cured or controlled by antibiotic treatment, or there may be few effective drug choices

In some cases, the illnesses can lead to disability ordeath

WHY SHOULD YOU BE WORRIED ABOUT ANTIBIOTIC RESISTANCE?

Antibiotics were once considered the solution to most infectious diseases. Unfortunately, the misuse and overuse of antibiotics, combined with bacteria’s ability to resist treatment, mean that antibiotics are no longer as effective

Antibiotic resistance is now a worldwide public health problem. Almost all bacteria have developed some form of resistance, making antibiotics less effective at treating serious infections

Someone with an infection that is resistant to a certain medicine can pass that resistant infection to other people. Hard-to-treat infectious diseases can threaten whole communities. It's especially dangerous for young children, elderly, and people with weakened immune systems

HOW CAN WE STOP THE SPREAD OF ANTIBIOTIC RESISTANCE?

Use antibiotics wisely

Don’t expect to get antibiotics every time you have a respiratory infection

Know when it’s effective to use antibiotics and don’t use them for viral infections such as colds, flu, coughs, and most sore throats

Even with some bacterial infections, you will usually recover just as quickly without antibiotics

Treat viral infections responsibly

Don’t pressure your doctor for antibiotics when you have a viral infection

Instead, talk to your doctor or pharmacist about ways to feel better when you are ill

There are medicines you can take to relieve your symptoms

Take antibiotics exactly as prescribed

If you are prescribed antibiotics, follow the dose and schedule instructions exactly

Finish all the antibiotics you are given, even if you start to feel better

Do not share them with someone else or save them for another time

Never take antibiotics without a prescription

In many countries, it is possible to get antibiotics without a prescription

Using antibiotics when you don’t need them is a significant contributor to antibiotic resistance and will not make you feel better